Twenty-three Michigan residents have been charged for their involvement in two illegal schemes to defraud Medicare of more than $61.5 million by paying kickbacks and bribes and billing Medicare for unnecessary medical services that were never provided, the Justice Department said on Tuesday
WASHINGTON (Pakistan Point News / Sputnik - 07th February, 2023) Twenty-three Michigan residents have been charged for their involvement in two illegal schemes to defraud Medicare of more than $61.5 million by paying kickbacks and bribes and billing Medicare for unnecessary medical services that were never provided, the Justice Department said on Tuesday,
"According to court documents, Walid Jamil, 62, and Jalal Jamil, 69, both of Oakland County, owned and operated several home health agencies in the Detroit metropolitan area," the department said in a press release. "They allegedly concealed their ownership interest in these agencies using straw owners - including family members and other associates - and submitted approximately $50 million in fraudulent home health care claims to Medicare."
Both men paid bribes to other co-conspirators to recruit patients in violation of the Federal Anti-Kickback Statute, according to the release.
"These patients did not need home health care, did not qualify for home health care under Medicare rules, and in many instances were not actually provided the care for which Medicare was billed," it said. "Walid and Jalal Jamil allegedly entered into quid pro quo relationships with physician clinics to receive the necessary information to fraudulently bill Medicare. Based on their fraudulent claims, Walid and Jalal Jamil received more than $43 million from Medicare, which they misappropriated for their personal benefit."
Other people charged in this scheme include employees of the Jamil home health agencies and a registered nurse employed by the health agencies as well as recruiters paid by various Jamil home health agencies to refer them Medicare beneficiaries for home health services that were then billed to Medicare, even though the claims were not eligible for reimbursement.
Anther scheme involves Radwan Malas, 43, of Oakland County, who operated home visiting physician company Infinity and allegedly ordered the physicians he employed to certify patients referred by Walid Jamil and Jalal Jamil for medically unnecessary home health services.
As part of this scheme, the defendants billed Medicare more than $11.5 million in fraudulent claims and they were paid almost $4 million, which they used for their personal use. DOJ officials alleged that Malas laundered the money gained from illegal financial transactions.
